USA. Reports show problems with provision of health care

Citation

(2003), "USA. Reports show problems with provision of health care", International Journal of Health Care Quality Assurance, Vol. 16 No. 7. https://doi.org/10.1108/ijhcqa.2003.06216gab.007

USA. Reports show problems with provision of health care

USA

Reports show problems with provision of health care

Keywords: Health care, Cost, Staff, Employment, Turnover

Reports published in the spring indicated problems with the provision of health care in the USA.

A report by the National Coalition on Health Care (NCHC), "Charting the cost of inaction", says that as many as 53.7 million Americans will be without health insurance by 2006 unless there is major, comprehensive reform of the nation's health-care system. The report also says that, if present trends continue, the average annual premium for employer-sponsored family health coverage by 2006 will be $14,545.

At a briefing in Washington in May when the report was released, top business leaders and representatives of major labour and consumer organizations and the country's second largest public pension fund pointed out the magnitude of the problems of cost, coverage, and quality in the health-care system and the effects on their business, their employees, and the people they represent. They said that US businesses could not continue to sustain the current rate of increase in the cost of health insurance. The costs are hurting their profitability, their viability, and their ability to continue to provide health insurance to their employees and families. That, in turn, hurts their employees, their shareholders, and the economy.

Henry E. Simmons, MD, president of the Coalition, said:

"Our health-care system is in crisis, and the large number of businesses and other organizations that have joined our Coalition over the past year is a dramatic indication of the strong, broad, and growing support for comprehensive health-care reform within all segments of our society. Our near 100 member organizations employ or represent 150 million people, and they recognize that the cost of inaction – of not making the systematic changes that are necessary – over time will be far greater than the cost of action."

Problems have also been identified in the long-term care sector. Analysis by the American Health Care Association (AHCA) and a new study by the Department of Health and Human Services (DHHS) and US Department of Labor (DoL) show problems with the provision of long-term care. The AHCA analysis shows that the USA already requires almost 100,000 health-care professionals to immediately meet existing long-term care needs, while the joint DHHS/DoL report estimates that the USA will need between 5.7 million to 6.5 million nurses, nurse aides, home health and personal care workers by 2050 to care for the 27 million Americans who will then require long-term care, double the numbers requiring long-term care in 2000.

The new AHCA analysis of 2002long-term care staffing, an updateto a similar 2001 study, surveyed approximately 16,500 nursing homes throughout the USA, and reportson information collected across five nursing staff positions: directors of nursing (DONs), registered nurses (RNs) with administrative responsibilities, staff RNs, licensed practical and vocational nurses (LPNs), and certified nurse assistants (CNAs). It shows that in 2002 vacancy rates were slightly improved over 2001, but there were nearly 96,000 vacancies across all nursing positions. This breaks down into a shortage of 4.8 per cent for DONs, 8.1 per cent for admin RNs, 15 per cent for staff RNs, 13.2 per cent for LPNs and 8.5 per cent for CNAs.

In addition to the shortages, there are also high turnover rates: 49.5 per cent for DONs, 35.5 per cent for admin RNs, 48.9 per cent for staff RNs, 48.9 per cent for LPNs and 71.1 per cent for CNAs.

Charles H. Roadman II, MD, CNA, President and CEO of AHCA and the National Center for Assisted Living (NCAL), said:

"This ongoing study of our nation's nursing home workforce clearlydemonstrates the need for publicpolicy initiatives directed towards recruiting, training and retaining the USA's skilled nursing workforce – especially the key frontline caregivers, who provide as much as 80 per cent of direct patient care. In addition to the chronic underfunding of Medicaid, the high vacancy and turnover rates of key frontline nursing personnel contribute to the underlying fragility of the nation's long-term care workforce."

Further information: Additionalinformation on the Coalition and a copy of "Charting the cost of inaction" can be found at www.nchc.org The complete AHCA staffing analysis, which also includes regional and state-specific data on turnover and vacancy rates, can be accessed at www.ahca.org